ABS Surgical Critical Care study guide
ABS Surgical Critical Care · Work through your exam, one topic at a time.
Surgical Critical Care certification is an ABS specialty credential for surgeons who care for patients of all ages with acute, life-threatening, or potentially life-threatening surgical conditions. The ABS describes the specialty as combining nonoperative supportive care techniques for critically ill patients with a broad understanding of how critical surgical illness relates to surgical procedures, plus specialized expertise in physiologic responses to trauma, burns, and inflammation and in comorbidities and complications unique to surgical patients. The ABS Surgical Critical Care study guide has 5 sections and about 1,617 words.
01Biology of Critical Illness and Support of Organ System Function
Critical illness is best understood as a failure of oxygen delivery and substrate use relative to demand, layered on a dysregulated inflammatory and neuroendocrine response. Candidates must be fluent in oxygen delivery (DO2 = cardiac output × arterial oxygen content), the determinants of oxygen content (hemoglobin, saturation, dissolved oxygen), and the balance with consumption (VO2).
348 words, about 2 min02Physiologic Responses to Trauma, Burns, and Inflammation
The injured patient mounts a stereotypic stress response: sympathetic activation with catecholamine surge, hypothalamic-pituitary-adrenal axis activation with cortisol release, and a cytokine cascade (TNF, IL-1, IL-6) producing fever, catabolism, and capillary leak. The ebb phase (hypoperfusion, low metabolic rate) transitions to the flow phase (hypermetabolism, hyperglycemia, negative nitrogen balance, sodium and water retention).
325 words, about 2 min03Comorbidities and Complications Unique to Surgical Patients
Surgical critical illness is shaped by preexisting disease and by procedure-specific complications. Candidates should understand how diabetes (stress hyperglycemia, impaired wound healing), chronic kidney disease (volume and electrolyte fragility, drug dosing), cirrhosis (coagulopathy that is rebalanced, encephalopathy, varices), obesity (airway difficulty, dosing by adjusted body weight, venous thromboembolism risk), and cardiac disease (perioperative ischemia, arrhythmia) alter ICU management.
305 words, about 2 min04Nonoperative Supportive Care Techniques
Supportive care is active medicine. Candidates must know mechanical ventilation modes and weaning (spontaneous breathing trials, sedation interruption, lung-protective settings), analgesia-first sedation strategies, and the ABCDEF bundle to reduce delirium and ventilator days.
317 words, about 2 min05Critical Illness and Surgical Procedures, Leadership, and ICU Administration
The relationship between critical illness and surgery is bidirectional: critical illness complicates operative timing and risk, and surgery creates critical illness. Candidates must understand preoperative risk assessment (frailty, functional status, emergency versus elective timing), the concept of damage-control surgery with staged reoperation, and postoperative triage to ICU versus ward.
322 words, about 2 min